<!DOCTYPE html>
<html>
<head>
<meta charset="UTF-8">
<title>个人信息添加页面</title>
<link rel="stylesheet" type="text/css" href="common/bootstrap/css/bootstrap.css" media="all">
<script type="text/javascript" src="common/bootstrap/js/jquery.min.js"></script>
<link href="common/bootstrap/css/bootstrap.min.css" rel="stylesheet">
<script src="common/bootstrap/js/bootstrap.min.js"></script>
<script src="common/bootstrap/js/jquery.cookie.js" type="text/javascript" charset="utf-8"></script>
<!-- 添加时候的，省市县下拉框展示 -->
<script type="text/javascript" src="js/Province_city_county.js"></script>
<script type="text/javascript" src="js/Province_city_county2.js"></script>
<!-- 添加时候的，下拉框展示 -->
<script type="text/javascript" src="js/Add_personal_information_select.js"></script>
</head>
<body>
	<div class="container">
		<form action="" id="form_personal" class="form-horizontal">
			<div class="form-group col-sm-12" style="height: 50px;">
				<h2>
					<small style="color: red;"><b>个人信息：</b></small>
				</h2>
			</div>
	        <div class="form-group col-sm-8">
	            <label for="firstname" class="col-sm-3 control-label">姓名
	            	<i style="color: red; font-size: 16px;">*</i>
	            </label>      
	            <div class="col-sm-3" >         
	               <input type="text" class="form-control" name="name" id="userName" placeholder="请输入名字"> 
	               
	            </div>
	            <label for="firstname" class="col-sm-2 control-label">曾用名</label>      
	            <div class="col-sm-4">         
	               <input type="text" class="form-control" name="formername" id="firstname" placeholder="请输入曾用名">      
	            </div>  
	        </div>
	        <div class="form-group col-sm-8">
	            <label for="firstname" class="col-sm-3 control-label"></label>      
	            <div class="col-sm-3" id="userNames" >         
	            </div>
	            <label for="firstname" class="col-sm-2 control-label"></label>      
	            <div class="col-sm-4">         
	            </div>  
	        </div>
	        <div class="form-group col-sm-12">
	         	<label for="firstname" class="col-sm-2 control-label">性别</label>      
	            <div class="col-sm-2">         
				   	<label class="radio-inline">
			       		<input type="radio" name="gender" value="1" checked>男
			     	</label>
			     	<label class="radio-inline">
			      		<input type="radio" name="gender" value="0">女
			     	</label>
	            </div>
	            <label for="firstname" class="col-sm-1 control-label">民族
	            	<i style="color: red; font-size: 16px;">*</i>
	            </label>      
	            <div class="col-sm-3">         
				   <input name="national" class="form-control" placeholder="请输入民族">
	            </div>
	        </div>
	        <div class="form-group col-sm-12">
	            <label for="firstname" class="col-sm-2 control-label">来本地时间</label>      
	            <div class="col-sm-2">         
	            	<input name="localtimes" type="date" class="form-control">
	            </div>
	            <label for="firstname" class="col-sm-1 control-label">证件号
	            	<i style="color: red; font-size: 16px;">*</i>
	            </label>      
	            <div class="col-sm-3">         
	            	<input name="citizenshipnumber" id="identitynumber" class="form-control" placeholder="请输入身份证号">
	            </div>
	        </div> 
	        <div class="form-group col-sm-12">
	            <label for="firstname" class="col-sm-2 control-label"></label>      
	            <div class="col-sm-2">         
	            </div>
	            <label for="firstname" class="col-sm-1 control-label"></label>      
	            <div class="col-sm-3" id="identitynumbers" >         
	            </div>
	        </div> 
	        <label for="firstname" class="col-sm-2">户籍详细地址
	        	<i style="color: red; font-size: 16px;">*</i>
	        </label> 
	        <div class="form-group col-sm-12">
	            <label for="firstname" class="col-sm-2 control-label">省</label>      
	            <div class="col-sm-2">         
	            	<select name="province" id="province" class="form-control">
					</select>
				</div>
				<label for="firstname" class="col-sm-1 control-label">市</label>
				<div class="col-sm-3">
					<select name="city" id="city" class="form-control">
					</select>
				</div>
				<label for="firstname" class="col-sm-1 control-label">县</label>
				<div class="col-sm-3">
					<select name="county" id="county" class="form-control">
					</select>
				</div>
			</div>
			<div class="form-group col-sm-12"
				style="border-bottom: 1px dashed black;">
				<label for="firstname" class="col-sm-2 control-label">乡</label>
				<div class="col-sm-2">
					<input name="township" id="" class="form-control"
						placeholder="请输入乡">
				</div>
				<label for="firstname" class="col-sm-1 control-label">村（社区）</label>
				<div class="col-sm-3">
					<input name="village" id="" class="form-control"
						placeholder="请输入村（社区）">
				</div>
				<label for="firstname" class="col-sm-1 control-label">户（楼道地址）</label>
				<div class="col-sm-3">
					<input name="gates" id="" class="form-control" placeholder="请输入信息">
				</div>
			</div>
			<label for="firstname" class="col-sm-2">现居住地地址</label>
			<div class="form-group col-sm-12">
				<label for="firstname" class="col-sm-2 control-label">省</label>
				<div class="col-sm-2">
					<select name="province2" id="province2" class="form-control">
					</select>
				</div>
				<label for="firstname2" class="col-sm-1 control-label">市</label>
				<div class="col-sm-3">
					<select name="city2" id="city2" class="form-control">
					</select>
				</div>
				<label for="firstname" class="col-sm-1 control-label">县</label>
				<div class="col-sm-3">
					<select name="county2" id="county2" class="form-control">
					</select>
				</div>
			</div>
			<div class="form-group col-sm-12"
				style="border-bottom: 1px dashed black;">
				<label for="firstname" class="col-sm-2 control-label">乡</label>
				<div class="col-sm-2">
					<input name="township2" id="" class="form-control"
						placeholder="请输入信息">
				</div>
				<label for="firstname" class="col-sm-1 control-label">村（社区）</label>
				<div class="col-sm-3">
					<input name="village2" id="" class="form-control"
						placeholder="请输入信息">
				</div>
				<label for="firstname" class="col-sm-1 control-label">户（楼道地址）</label>
				<div class="col-sm-3">
					<input name="gates2" id="" class="form-control" placeholder="请输入信息">
				</div>
			</div>
			<label for="firstname" class="col-sm-2" style="color: red;">本人联系方式</label>
			<div class="form-group col-sm-12">
				<label for="firstname" class="col-sm-2 control-label">固定电话</label>
				<div class="col-sm-2">
					<input name="fixedtelephone" id="" class="form-control"
						placeholder="如：3013-3214567">
				</div>
				<label for="firstname" class="col-sm-2 control-label">移动电话
					<i style="color: red; font-size: 16px;">*</i>
				</label>
				<div class="col-sm-3">
					<input name="mobilephone" id="phone" class="form-control" placeholder="如：12345678978">
				</div>
				<label for="firstname" class="col-sm-3 control-label" id="spPhone"></label>
			</div>
			<label for="firstname" class="col-sm-2" style="color: red;">紧急联系方式</label>
			<div class="form-group col-sm-12">
				<label for="firstname" class="col-sm-2 control-label">联系人
					<i style="color: red; font-size: 16px;">*</i>
				</label>
				<div class="col-sm-2">
					<input name="emergencycontact" id="emergencycontact" class="form-control">
				</div>
				<label for="firstname" class="col-sm-1 control-label">固定电话</label>
				<div class="col-sm-3">
					<input name="emergencycontactfixedtelephone" id="" class="form-control" placeholder="如：3013-3214567">
				</div>
				<label for="firstname" class="col-sm-1 control-label">移动电话
					<i style="color: red; font-size: 16px;">*</i>
				</label>
				<div class="col-sm-3">
					<input name="emergencycontactmobilephone" id="phones" class="form-control" placeholder="如：12345678978">
				</div>
			</div>
			<div class="form-group col-sm-12">
				<label for="firstname" class="col-sm-4 control-label" id="emergencycontacts"></label> 
				<label for="firstname" class="col-sm-4 control-label"></label> 
				<label for="firstname" class="col-sm-4 control-label" id="spPhones"></label>
			</div>
			<label for="firstname" class="col-sm-2">身体状况</label>
			<div class="form-group col-sm-12">
				<label for="firstname" class="col-sm-2 control-label">身高
					<i style="color: red; font-size: 16px;">*</i>
				</label>
				<div class="col-sm-2">
					<input name="height" id="height" class="form-control" placeholder="如：175">
				</div>
				<label for="firstname" class="col-sm-1 control-label">体重
					<i style="color: red; font-size: 16px;">*</i>
				</label>
				<div class="col-sm-3">
					<input name="weight" id="weights" class="form-control" placeholder="如：56">
				</div>
				<label for="firstname" class="col-sm-1 control-label">血型</label>
				<div class="col-sm-3">
					<select name="bloodtypeid" id="bloodtype" class="form-control">
					</select>
				</div>
			</div>
			<div class="form-group col-sm-12">
				<label for="firstname" class="col-sm-4 control-label" id="heights"></label>	
				<label for="firstname" class="col-sm-3 control-label" id="weighte"></label>
			</div>
			<div class="form-group col-sm-12">
				<label for="firstname" class="col-sm-2 control-label">文化程度</label>
				<div class="col-sm-2">
					<select name="cultureid" id="culture" class="form-control">
					</select>
				</div>
				<label for="firstname" class="col-sm-1 control-label">宗教信仰</label>
				<div class="col-sm-3">
					<select name="religiousid" id="religious" class="form-control">
					</select>
				</div>
				<label for="firstname" class="col-sm-1 control-label">政治面貌</label>
				<div class="col-sm-3">
					<select name="faceid" id="face" class="form-control">
					</select>
				</div>
			</div>
			<div class="form-group col-sm-12">
				<label for="firstname" class="col-sm-2 control-label">健康状况</label>
				<div class="col-sm-2">
					<select name="healthid" id="health" class="form-control">
					</select>
				</div>
				<label for="firstname" class="col-sm-1 control-label">从业状况</label>
				<div class="col-sm-3">
					<select name="workingconditionsid" id="workingconditions"
						class="form-control">
					</select>
				</div>
				<label for="firstname" class="col-sm-1 control-label">婚姻状况</label>
				<div class="col-sm-3">
					<select name="maritalstatusid" id="maritalstatus"
						class="form-control">
					</select>
				</div>
			</div>
			<div class="form-group col-sm-12">
				<label for="firstname" class="col-sm-2 control-label"></label>
				<div class="col-sm-8">
					<button type="button" id="btn_personal" class="btn btn-primary btn-block">下一项（保存）</button>
				</div>
			</div>
			<div class="form-group col-sm-12" style="height: 50px;"></div>
		</form>
		
	</div>


</body>
</html>